In an adult subject, Mallet Finger is a situation of a finger's disfigurement caused by damage to the tendon system which straightens the finger, preventing active straightening of the last joint in the affected finger.
Mallet finger is common among athletes and it mainly appears after a direct trauma to the finger due to a fall, as well as injuries in basketball and volleyball.
The causes of Mallet Finger
Mallet finger may also be caused by invasive injury damaging the continuity of the straightening tendon of the affected joint or by a fracture in the bone around the tendon's connection with it.
Characteristics of Mallet Finger
The characteristics of mallet finger are pain and swelling around a distal joint of the affected finger, a disfigurement of the joint's bending without the ability to actively straighten the distal part of the finger.
Diagnosing Mallet Finger
It is highly important to be checked by a hand surgeon in order to assess the injury's severity.
In observation - a typical appearance of bending without the ability to straighten a distal joint of the affected finger (the appearance of a wooden mallet). Internal bleeding around or under the finger nail shows the power of the impact and arouses suspicion for a fracture of torn tendon.
X-Ray Radiography - in case of a fracture on the dorsal side of the bone's base, at the connection area of the straightening tendon, the fracture's size and influence on the joint's stability is checked. If no fracture exists, this arouses suspicion for a tear in the straightening system.
Treatment options for Mallet Finger
Planning the treatment follows a clinical examination of the finger and X-Ray Radiography. In case there is no fracture and no external injury of the skin 0 the recommended treatment is conservative and amounts to wearing a splint straightening the distal joint of the affected finger and allowing the use of the rest of that finger's joints. The splint has to be worn continually without removal for approximately two months, after which there is need for physical therapy for recovering the finger's movement ranges.
In case a fracture is diagnosed, its size is assessed as well as the existence of damage to the joint's stability. If the fracture is large and if it damaged the stability - surgery is recommended. During this surgical operation, two pins are inserted through the skin (without cutting the skin open) allowing for the joint's stabilization until the fracture heals, at which point they are removed.
In case of a fracture without risk of damage to the joint's stability it is possible to treat it using a splint as described above. In this case the splint has to be set for 4-6 weeks and follow-up uses X-Ray Radiography.
Dr. Alon Covo